Cancer incidence attributable to red and processed meat consumption in Alberta in 2012

Anne Grundy; Abbey E. Poirier; Farah Khandwala; Alison McFadden; Christine M. Friedenreich; Darren R. Brenner

doi:10.9778/cmajo.20160036

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Figure 1
Proportion of men and women in the Alberta's Tomorrow Project cohort who consume more than 500 grams of red and processed meat per week, by age group.

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Table 1: Red meat consumption and the proportion of the population in each of 10 consumption categories, by age and sex

Meat consumption category, g/d	Age, yr
	35-44		45-54		55-64		≥ 65
	g/d	%	g/d	%	g/d	%	g/d	%
Men
1: < 14.5	8.52	2.66	8.67	3.77	9.13	4.67	8.98	5.89
2: 14.5-21.4	18.27	4.00	18.09	4.36	17.97	6.31	17.94	9.11
3: 21.5-27.9	25.06	4.92	24.58	5.52	24.80	7.53	24.92	11.58
4: 28.0-34.2	31.04	6.56	31.10	6.90	31.09	7.25	31.38	7.61
5: 34.3-41.3	37.53	7.48	37.65	7.86	37.58	8.94	38.05	9.97
6: 41.4-49.2	45.54	8.40	45.60	9.43	45.00	10.20	45.51	9.75
7: 49.3-59.2	54.26	11.31	54.17	11.07	54.16	10.82	53.59	9.65
8: 59.3-73.3	65.57	14.14	65.98	13.21	65.88	12.16	65.95	13.72
9: 73.4-100.3	85.31	16.77	85.73	16.28	85.92	15.14	86.82	10.93
10: ≥ 100.4	154.29	23.74	154.03	21.60	144.21	16.98	149.84	11.79
Mean	77.22		73.81		65.00		57.04
Women
1: < 14.5	9.28	10.22	8.95	13.57	9.31	14.86	9.07	19.20
2: 14.5-21.4	18.05	11.48	18.07	12.17	17.92	15.03	18.02	15.79
3: 21.5-27.9	24.86	12.01	24.71	12.22	24.66	12.34	24.87	14.67
4: 28.0-34.2	30.97	11.40	30.98	11.27	30.85	11.10	30.98	11.50
5: 34.3-41.3	37.54	12.33	37.59	11.49	37.72	10.76	37.44	10.19
6: 41.4-49.2	45.07	10.46	45.22	10.28	45.28	10.71	44.69	8.70
7: 49.3-59.2	54.21	10.66	53.81	9.77	53.69	8.24	53.87	8.02
8: 59.3-73.3	65.65	9.11	65.58	7.97	65.82	7.83	65.72	5.66
9: 73.4-100.3	84.45	7.80	84.19	7.03	85.00	5.87	84.47	4.10
10: ≥ 100.4	131.99	4.53	132.78	4.22	134.37	3.27	129.22	2.18
Mean	43.20		40.90		38.41		33.81

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Table 2: Processed meat consumption and the proportion of the population in each of 10 consumption categories, by age and sex

Meat consumption category, g/d	Age, yr
	35-44		45-54		55-64		≥ 65
	g/d	% (95% CI)	g/d	% (95% CI)	g/d	% (95% CI)	g/d	% (95% CI)
Men
1: < 1.7	0.88	2.7 (2.1-3.3)	0.92	3.9 (3.2-4.5)	0.93	5.4 (4.5-6.3)	0.97	6.3 (4.8-7.9)
2: 1.7-3.1	2.40	2.7 (2.1-3.2)	2.45	3.0 (2.5-3.6)	2.45	5.5 (4.6-6.4)	2.45	6.3 (4.8-7.9)
3: 3.1-4.5	3.67	4.7 (3.9-5.4)	3.72	5.7 (5.0-6.5)	3.71	8.5 (7.4-9.6)	3.66	8.0 (6.3-9.8)
4: 4.5-6.2	5.25	6.1 (5.2-7.0)	5.24	7.6 (6.7-8.5)	5.23	9.5 (8.4-10.7)	5.24	9.7 (7.8-11.5)
5: 6.2-8.2	7.23	9.3 (8.2-10.3)	7.17	9.7 (8.8-10.7)	7.25	10.4 (9.2-11.6)	7.21	12.2 (10.1-14.3)
6: 8.2-11.0	9.59	9.7 (8.7-10.8)	9.53	8.8 (7.8-9.7)	9.55	10.0 (8.8-11.1)	9.61	10.6 (8.6-12.6)
7: 11.1-15.0	12.90	12.0 (10.8-13.2)	12.79	11.9 (10.8-12.9)	12.76	11.5 (10.3-12.8)	12.95	13.0 (10.8-15.1)
8: 15.0-21.5	17.96	13.9 (12.7-15.2)	18.11	14.4 (13.3-15.6)	18.11	12.2 (11.0-13.5)	18.23	11.5 (9.4-13.5)
9: 21.5-32.6	26.51	16.8 (15.4-18.1)	26.83	14.6 (13.4-15.8)	26.41	13.0 (11.7-14.3)	26.81	11.2 (9.2-13.3)
10: ≥ 32.6	56.94	22.1 (20.6-23.6)	56.57	20.4 (19.0-21.7)	54.45	13.9 (12.5-15.2)	50.70	11.2 (9.1-13.2)
Mean g/d	7.19		6.92		6.27		6.02
Women
1: < 1.7	0.97	9.7 (8.8-10.5)	0.99	13.7 (12.8-14.5)	1.02	16.8 (15.7-18.0)	0.96	20.0 (18.1-22.0)
2: 1.7-3.1	2.43	8.3 (7.5-9.0)	2.41	10.9 (10.1-11.7)	2.38	13.2 (12.1-14.2)	2.37	14.7 (12.9-16.4)
3: 3.1-4.5	3.68	10.4 (9.5-11.2)	3.65	12.7 (11.8-13.5)	3.66	13.6 (12.6-14.6)	3.68	13.6 (11.9-15.3)
4: 4.5-6.2	5.24	11.1 (10.2-11.9)	5.21	12.6 (11.7-13.4)	5.25	12.2 (11.2-13.2)	5.17	11.9 (10.3-13.4)
5: 6.2-8.2	8	12.6 (11.7-13.5)	7.16	11.9 (11.1-12.8)	7.23	11.7 (10.7-12.7)	7.17	9.1 (7.7-10.5)
6: 8.2-11.0	9.57	10.8 (10.0-11.7)	9.50	9.2 (8.4-9.9)	9.56	8.1 (7.3-8.9)	9.60	7.6 (6.3-8.9)
7: 11.1-15.0	12.69	10.9 (10.0-11.7)	12.83	9.3 (8.5-10.0)	12.80	7.7 (6.9-8.6)	12.89	6.0 (4.9-7.2)
8: 15.0-21.5	17.85	10.9 (10.0-11.7)	17.93	8.0 (7.3-8.7)	17.90	6.7 (5.9-7.4)	17.63	6.7 (5.5-7.9)
9: 21.5-32.6	24.94	9.2 (8.4-10.1)	26.30	7.5 (6.8-8.2)	26.11	5.4 (4.7-6.1)	26.09	6.1 (4.9-7.3)
10: ≥ 32.6	49.80	6.2 (5.5-6.9)	47.89	4.3 (3.8-4.8)	46.11	4.5 (3.9-5.2)	47.36	4.2 (3.2-5.2)
Mean g/d	5.38		4.78		4.42		4.22

Note: CI = confidence interval.

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Table 3: Estimated risks with consumption of red and processed meat and latency periods for calculating population attributable risk

Cancer site	Sex	RR estimate	Units, g/d	Risk per g/d	Source*	Latency period, yr
Red meat
Colorectal	Men	1.28	100	0.0025	WCRF 2011²	8
Colorectal	Women	1.05	100	0.00049	WCRF 2011²	8
Colon	Men	1.00	100	0	WCRF 2011²	8
Colon	Women	1.06	100	0.00058	WCRF 2011²	8
Rectum	All	1.18	100	0.0017	WCRF 2011²	8
Processed meat
Colorectal	Men	1.11	50	0.0021	WCRF 2011²	8
Colorectal	Women	1.09	50	0.0017	WCRF 2011²	8
Colon	Men	1.38	50	0.0064	WCRF 2011²	8
Colon	Women	1.64	50	0.0099	WCRF 2011²	8
Rectum	All	1.12	50	0.0023	WCRF 2011²	8

Note: RR = relative risk, WCRF = World Cancer Research Fund.

*Details concerning the meta-analysis that produced the RR found in the 2011 WCRF Continuous Update Project on Colorectal Cancer can be found at www.wcrf.org/sites/default/files/SLR_colorectal_cancer_2010.pdf

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Table 4: Cancer cases and proportions attributable to red meat intake in Alberta, 2012

Age at exposure, yr	Age at outcome, yr	Colorectal			Colon			Rectum
Age at exposure, yr	Age at outcome, yr	Total observed cases	PAR, % (95% CI)	EAC*	Total observed cases	PAR, % (95% CI)	EAC*	Total observed cases	PAR, % (95% CI)	EAC*
Men
35-44	43-52	96	17.9 (0-67.3)	17	38	8.5 (0-18.5)	3	58	12.3 (0-24.7)	7
45-54	53-62	280	17.2 (0-65.6)	48	139	8.2 (0-17.8)	11	141	11.8 (0-23.7)	17
55-64	63-72	320	15.3 (0-60.4)	49	177	7.2 (0-15.8)	13	143	10.4 (0-21.1)	15
≥ 65	≥ 73	383	13.6 (0-56.1)	52	260	6.4 (0-14.1)	17	123	9.2 (0-19.2)	11
Total		1079		166	614		44	465		50
Women
35-44	43-52	81	2.1 (0-14.4)	2	42	4.8 (0-10.7)	2	39	7 (0-14.5)	3
45-54	53-62	181	2.0 (0-13.4)	4	105	4.6 (0-10.2)	5	76	6.6 (0-13.9)	5
55-64	63-72	202	1.9 (0-13.0)	4	125	4.3 (0-9.5)	5	77	6.3 (0-13.0)	5
≥ 65	≥ 73	356	1.6 (0-11.5)	6	265	3.8 (0-8.4)	10	91	5.5 (0-11.5)	5
Total		820		15	537		22	283		18
Total†
35-44	43-52	177	10.7	19	80	6.6	5	97	10.2	10
45-54	53-62	461	11.2	52	244	6.6	16	217	10	22
55-64	63-72	522	10.1	53	302	6	18	220	9	20
≥ 65	≥ 73	739	7.8	58	525	5.1	27	214	7.6	16
Total		1899		181	1151		66	748		68

Note: CI = confidence interval, EAC = excess attributable cases, PAR = population attributable risk.

*Numbers rounded to nearest case.

†Values for Total (men and women combined) were estimated based on excess attributable cases estimated for men and women separately and not directly from population attributable risk models. For this reason, no confidence intervals are available, and totals may not match individual totals for men and women.

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Table 5: Cancer cases and proportions attributable to processed meat intake in Alberta, 2012

Age at exposure, yr	Age at outcome, yr	Colorectal			Colon			Rectum
Age at exposure, yr	Age at outcome, yr	Total observed cases	PAR, % (95% CI)	EAC	Total observed cases	PAR, % (95% CI)	EAC	Total observed cases	PAR, % (95% CI)	EACb
Men
35-44	43-52	96	4.8 (0-16.0)	5	38	9.9 (5.7-13.9)	4	58	5.2 (0-11.2)	3
45-54	53-62	280	4.5 (0-15.5)	13	139	9.3 (5.3-13.3)	13	141	4.9 (0-10.5)	7
55-64	63-72	320	3.6 (0-12.7)	12	177	7.5 (4.2-10.7)	13	143	3.9 (0-8.4)	6
≥ 65	≥ 73	383	3.2 (0-11.0)	12	260	6.6 (3.8-9.5)	17	123	3.5 (0-7.4)	4
Total		1079		41	614		47	465		20
Women
35-44	43-52	81	2.1 (0-6.9)	2	42	5.1 (2.8-7.4)	2	39	2.7 0-5.7)	1
45-54	53-62	181	1.7 (0-5.9)	3	105	4.3 (2.4-6.1)	4	76	2.2 (0-4.9)	2
55-64	63-72	202	1.5 (0-5.2)	3	125	3.9 (2.2-5.6)	5	77	2.0 (0-4.4)	2
≥ 65	≥ 73	356	1.5 (0-5.1)	5	265	3.7 (2.1-5.4)	10	91	2.0 (0-4.2)	2
Total		820		13	537		21	283		6
Total†
35-44	43-52	177	3.6	6	80	7.4	6	97	4.2	4
45-54	53-62	461	3.4	16	244	7.1	17	217	4	9
55-64	63-72	522	2.8	15	302	6	18	220	3.3	7
≥ 65	≥ 73	739	2.4	18	525	5.1	27	214	2.8	6
Total		1899		54	1151		68	748		26

Note: CI = confidence interval, EAC = excess attributable cases, PAR = population attributable risk.

*Numbers rounded to nearest case.†Values for Total (men and women combined) were estimated based on excess attributable cases estimated for men and women separately and not directly from population attributable risk models. For this reason, no confidence intervals are available, and totals may not match individual totals for men and women.

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Table 6: Summary of cases and proportions of cancer in Alberta adults in 2012 attributable to the consumption of red and processed meat*

Cancer site†	Total			Men			Women
Cancer site†	Observed cases‡	Excess attributable cases§	% Attributable¶	Observed cases‡	Excess attributable cases§	% Attributable¶	Observed cases‡	Excess attributable cases§	% Attributable¶
Red meat
Colorectum	1899	181	9.5	1079	166	15.4	820	15	1.8
Colon	1151	66	5.7	614	44	7.1	537	22	4.1
Rectum	748	68	9	465	50	10.7	283	18	6.2
All associated cancers**	1899	181	9.5	614	166	15.4	537	15	1.8
All cancers††	15836	181	1.1	8155	166	2.0	7681	15	0.2
Processed meat
Colorectum	1899	54	2.9	1079	41	3.8	820	13	1.6
Colon	1151	68	5.9	614	47	7.6	537	21	4.0
Rectum	748	26	3.5	465	20	4.3	283	6	2.2
All associated cancers**	1899	54	2.9	1079	41	3.8	537	13	1.6
All cancers††	15836	54	0.3	8155	41	0.5	7681	13	0.2

*Red and processed meat consumption data for Alberta from Alberta's Tomorrow Project cohort, in which a diet history questionnaire was used to estimate the number of ounces of each of red (beef, pork, lamb, veal, venison, liver etc.) and processed (cold cuts, sausage, ham, hot dogs) meat consumed each day.

†Cancer incidence data obtained from the Alberta Cancer Registry. Data from 2012 were used for observed cancer cases for all cancer sites.

‡Number of observed cancer cases in Alberta in 2012 at individual cancer sites.

§Number of cancer cases at individual cancer sites that can be attributed to red and processed meat consumption.

¶Proportion of cancers at individual cancer sites attributable to red and processed meat consumption. Calculated as excess attributable cases/observed cases.

**Represents all cancers with a known association with red and processed meat consumption as listed in table. These values represent colorectal cancer, because colon and rectal cancers are subsets of this type.

††Represents all incident cancers in Alberta in 2012 in all age groups.